Medicine and Health Sciences Commons^™

Education And Training On Naloxone Administration For Healthcare Professionals: An Integrative Literature Review, Remigus C. Nwaokoro

DNP Qualifying Manuscripts

Abstract

Background: Healthcare professionals’ lack of knowledge and confidence in administering naloxone affects their willingness to inform at-risk patients about its use in the event of an overdose. The lack of understanding and confidence in using naloxone delays efforts to inform at-risk patients about this life-saving treatment for opioid overdose. This integrative literature review aimed to answer the following question: Do increased education and training enhance healthcare professionals' knowledge and confidence in administering naloxone and decrease the rate of opioid overdose fatalities?

Methodology: A comprehensive search of the literature (2019 and 2024) was conducted to identify studies of education …

Enhancing Newer Nicu Nurse Confidence With Resuscitation Through High-Fidelity, In-Situ Crisis Resource Management, Karen Rose

Doctor of Nursing Practice Final Manuscripts

Neonatal resuscitation is a low-volume, high-risk occurrence. Given the infrequency of resuscitation, newer neonatal intensive care unit (NICU) nurses may have little to no exposure to neonatal resuscitation events. This can lead to a lack of confidence in resuscitation skills, contributing to burnout, poor patient outcomes, and the potential for nursing turnover. This evidence-based practice project, guided by the Iowa Model Revised: Evidence-Based Practice to Promote Excellence in Health Care, focused on enhancing the perceived confidence in neonatal resuscitation skills among newer NICU nurses. To achieve this, multidisciplinary, high-fidelity, in-situ neonatal resuscitation crisis resource management (CRM) simulated events were implemented. …

Improving Anesthesia Clinicians’ Knowledge And Confidence When Selecting Prophylactic Antimicrobials For Patients On Concomitant Antimicrobial Therapy, Garry Gregson, Emily Shands

Doctor of Nursing Practice (DNP) Student Projects

Anesthesia clinicians at Barnes Jewish Hospital (BJH) in Saint Louis, Missouri experienced uncertainty and discomfort when they selected preoperative antibiotics for patients who were already receiving concomitant therapeutic antimicrobials (CTA) unrelated to surgical prophylaxis. Various evidence-based interventions were proposed to address this issue. The first intervention was the addition of pathogens of concern to the surgical antimicrobial prophylaxis (SAP) protocol at BJH. The second intervention was the creation of a reference table that supplemented the revised protocol and allowed clinicians to efficiently determine the pathogens of concern for each surgery. This also included the CTAs efficacy for preventing surgical site …

The Nurse's Lived Experience Of Transferring Nutrition Knowledge To Patients: A Descriptive Phenomenology, Kendrah Lynne Cunningham

Doctoral Dissertations and Projects

This descriptive phenomenological qualitative study aimed to gain insight into the nurse’s lived experience of transferring nutrition knowledge to patients. Nurses play an important role in assisting the patient to become more proficient in health and nutrition literacy to make proper choices related to their nutrition. It is necessary to evaluate the lived experience of the nurse in transferring nutrition knowledge to patients. There is a gap in the literature on nurses’ experience in providing nutrition knowledge to their patients. This descriptive phenomenological qualitative study examines the lived experience of nurses in transferring nutrition education to their patients. This was …

Mindfulness-Based Educational Module For Nurses Caring For Pediatric Mental Health Patients, Brianna Mai Desjardins, Katherine Marie Newnam

Graduate Publications and Other Selected Works - Doctor of Nursing Practice (DNP)

BACKGROUND: Emergency pediatric nurses have the added stress of not only caring for medical patients but must also care for patients experiencing mental health issues. Many nurses feel unprepared to care for this specialized patient population. To bridge this gap, mindfulness-based interventions (MBIs) have been shown to provide nurses with the skills needed to care for mental health patients. This same concept can be applied to pediatric patients. Pediatric-focused mindfulness-based techniques can be used to help pediatric patients manage their symptoms.

LOCAL PROBLEM: The setting for this project was an urban pediatric emergency department in East Tennessee. At the state …

Empowering Nursing Staff To Activate Rapid Response Teams: Using In Situ Simulation To Bolster Knowledge And Confidence, Elicia Egozcue, Marrice A. King, Natalie Bermudez, Nohemi Sadule Rios, Mayra Villalba, Ashley Miller

Nursing & Health Sciences Research Journal

Purpose: To examine the impact of in situ simulation (ISS) with scripting on nursing staff’s knowledge and confidence to initiate rapid response teams (RRTs) immediately after identifying patient condition deterioration. Background/Significance: Failure to rescue (FTR) related to delays in activation of RRT is on the rise, leading to poor patient outcomes. Lack of confidence, knowledge, and empowerment are associated with delayed activation of RRTs. As such, the nursing staff’s confidence is integral in activating RRTs and FTR prevention. In situ simulation may help nurses increase their confidence, thus empowering timely RRT initiation. Methods: This quantitative pretest–posttest study used a convenience …

Antimicrobial Resistance And Rational Prescription Practices: Knowledge, Perceptions And Confidence Of Health Profession Interns In Uganda, Shamim Nabidda, Rogers Ssennyonjo, Joseph Atwaru, Andrew Marvin Kanyike, Shiellah Baryayaka, Kennedy Pangholi, Jonans Tusiimire

School of Nursing & Midwifery, East Africa

Background

Antimicrobial resistance (AMR) is significantly driven by misuse and overuse of antibiotics. Graduate health profession interns often prescribe antimicrobials under minimum supervision.

Objectives

This study explored the knowledge, perceptions and confidence of health profession interns in Uganda regarding AMR and rational prescription practices.

Methods

This was a cross-sectional survey employing quantitative techniques carried out between October and November 2022 at six tertiary hospitals in Uganda. Health profession interns including doctors, nurses, midwives and pharmacists were recruited as study participants. Data were collected using online Kobo toolbox software. Data analysis was performed using STATA (StataCorp) version 16. Bivariate analysis and …

Increasing Medical-Surgical Nurses' Palliative Care Self-Efficacy Using The Cares Tool: A Quality Improvement Project, Rebekkah L. Stanko

Nursing (graduate) Student Scholarship

Background: Over 35% of all deaths in the United States occur in the acute care hospital setting, and 75% of end-of-life (EOL) patients require palliative care. Registered nurses (RNs) with strong palliative care self-efficacy (PCSE) promote positive death experiences for patients and families by minimizing patient suffering and maintaining clinical and ethical standards. Employers can enhance RNs’ PCSE through educational interventions and resources.

Problem: Inpatient acute care hospital RNs lack PCSE because acute care is traditionally curative, and RNs receive limited EOL care education.

Methods: A quality improvement project was conducted. Participants were a convenience sample of RNs …

Bridging The Gap: Educating Medical-Surgical Unit Nurses In A Large Hospital Organization On Sepsis Bundle Elements, Meara J. Matthews

Master's Projects and Capstones

Problem: Sepsis is a life-threatening response to infection that remains one of the leading causes of death worldwide. Based off results obtained from a pre-education survey of nurses on a medical-surgical unit in a large hospital organization, there is an opportunity to increase knowledge and confidence level regarding sepsis and care of septic patients so that nurses are prepared to detect sepsis early and intervention can begin.

Context: The project is being conducted in a medical-surgical unit at a large hospital organization in Northern California. The data from the survey includes 17 nurses on the unit who completed the pre-education …

Educating Medical-Surgical Nurses In A Large Hospital Organization On Sepsis Bundle Elements, Amanda H. Tran

Master's Projects and Capstones

Problem: According to a pre-survey collected, approximately six percent of medical-surgical nurses report expert knowledge with the “Inpatient Handoff Sepsis Bundle Checklist,” a checklist that details interventions to be taken when a patient is diagnosed with sepsis. About thirty-five percent of these nurses also report expert confidence levels in caring for sepsis patients. Therefore, there is an opportunity to provide education so that nurses may confidently and competently care for sepsis patients.

Context: A medical-surgical unit at Hospital A affiliated with a large, non-profit, integrated healthcare system located in the San Francisco Bay Area.

Intervention: Create an educational handout to …

Educating Medical-Surgical Nurses In A Large Hospital Organization On Sepsis Bundle Elements, Christopher N. Guinto

Master's Projects and Capstones

Problem: Results from a voluntarily anonymous pre-survey about sepsis revealed that a majority of the seventeen nurses assessed themselves below an "expert knowledge '' level. The survey results present an opportunity to improve the nurses’ knowledge and confidence in nursing response and improve patient outcomes with sepsis.

Context: The quality improvement (QI) project was conducted on a medical-surgical unit in a large Northern California hospital.

Intervention: A QI team initiated evidenced-based practice research and created an educational sepsis handout for nurses to increase sepsis knowledge and confidence.

Measures: The self-assessment pre-survey would be compared to the responses from the post-survey. …

The Dedicated Education Unit: Increasing Capacity And Confidence, Heather Marie Van Housen

Doctor of Nursing Practice (DNP) Projects

Background: In the American Association of Colleges of Nursing (AACN) 2020 annual survey, nursing schools turned away 66,274 entry-level applications to baccalaureate nursing programs in the United States due to a faculty shortage and clinical placement sites (AACN, 2021).

Local Problem: Hospitals need more qualified nurses to meet community needs. The need for clinical faculty and additional clinical placement sites disrupts the workforce pipeline through local nursing schools. A new approach to clinical education is needed to prepare more students for the growing complexities of independent nursing practice.

Methods: Dedicated Education Unit (DEU) implementation to expand pre-licensure nursing student clinical …

Simulation: Are We Doing Enough?, Christopher Doneski

DNP Research Projects

Abstract

Objective: Simulation is a widely utilized tool for training healthcare professionals. Research examines and details the benefits of simulation, although there is no recommendation for the most effective amount. This project aims to determine if increased amounts of simulation benefit nursing residents' confidence and self-efficacy regarding the deteriorating patient. Method: Based on a review of literature regarding simulation use, nursing transition-to-practice programs, and patient deterioration, nursing residents were exposed to varying amounts of simulation and asked to respond to questionnaires regarding their perceived self-efficacy, satisfaction, and self-confidence utilizing a quasi-experimental, comparative design approach. Qualitative data was obtained through debriefing …

Thirty-Second Mindful Body Scan Meditation For Bedside Nurses, Shruti Balwalli-Udyawer

Walden Dissertations and Doctoral Studies

Compassion fatigue, or secondary traumatic stress, is a state of physical and mental exhaustion caused by an inability to cope with the everyday environment that reduces the ability of the nurse to provide high-quality health care to a patient. The purpose of this staff education project, guided by Selye’s general adaption syndrome , was a 6-week, 30-second mindfulness exercise program to promote stress reduction for cardiac step-down and medical-surgical nurses. In this quantitative, pre- and posttest study, the Perceived Stress Scale was completed by a sample of 24 nurses who met the inclusion criteria. The practice focused whether educating nurses …

Thirty-Second Mindful Body Scan Meditation For Bedside Nurses, Shruti Balwalli-Udyawer

Walden Dissertations and Doctoral Studies

Compassion fatigue, or secondary traumatic stress, is a state of physical and mental exhaustion caused by an inability to cope with the everyday environment that reduces the ability of the nurse to provide high-quality health care to a patient. The purpose of this staff education project, guided by Selye’s general adaption syndrome , was a 6-week, 30-second mindfulness exercise program to promote stress reduction for cardiac step-down and medical-surgical nurses. In this quantitative, pre- and posttest study, the Perceived Stress Scale was completed by a sample of 24 nurses who met the inclusion criteria. The practice focused whether educating nurses …

Thirty-Second Mindful Body Scan Meditation For Bedside Nurses, Shruti Balwalli-Udyawer

Walden Dissertations and Doctoral Studies

Compassion fatigue, or secondary traumatic stress, is a state of physical and mental exhaustion caused by an inability to cope with the everyday environment that reduces the ability of the nurse to provide high-quality health care to a patient. The purpose of this staff education project, guided by Selye’s general adaption syndrome , was a 6-week, 30-second mindfulness exercise program to promote stress reduction for cardiac step-down and medical-surgical nurses. In this quantitative, pre- and posttest study, the Perceived Stress Scale was completed by a sample of 24 nurses who met the inclusion criteria. The practice focused whether educating nurses …

Using Education To Promote Waste Segregation And Waste Reduction In The Operating Room: A Quality Improvement Initiative, Sarah E. Landgraf

Master's Theses and Capstones

Background: The operating room (OR) is known to be one of the largest producers of medical waste and of the surgical specialties, orthopedic surgery tends to the largest portion of this. Waste from the OR can be mitigated by recycling non-contaminated materials. This reduces the number of raw materials needed to create new products, decreases landfill use, and lowers hospital costs.

Local Problem: It was observed that a gap in knowledge existed related to recyclables in the OR of a large medical center in New England. Also, it was observed that there was potential for waste and recycling to be …

Educational Intervention To Increase Confidence And Knowledge Of Pediatric Nurses Caring For Pediatric Mental Health Patients, Alexa M. Wroblewski, Allyson Neal, Janie R. Holmes

Graduate Publications and Other Selected Works - Doctor of Nursing Practice (DNP)

Background: Given the rise in the mental health crisis, there is an increase of non-psychiatric nurses caring for pediatric mental health patients. This crisis leads nurses to experience feelings of doubt, hopelessness, stress, and insecurities in caring for this population. These feelings, combined with a lack of support and training, create a powerlessness loop of care. Local problem: In a Pediatric ICU, there is a lack of training and resources available to the nurses caring for pediatric mental health patients. Despite the lack of training, 35% of total admissions in 2020 were pediatric patients experiencing an acute mental health crisis. …

Effects Of Telesimulation On The Health Literacy Knowledge, Confidence And Application Of Nursing Students, Susan Patton

Dissertations, Theses, and Capstone Projects

Background: Assessing and addressing health literacy (HL) in patients is an essential role of the nurse and a critical component of nursing student education. Yet, large gaps exist within nursing school curricula with regard to the development of HL knowledge and skills, and the confidence to implement practices that target HL. Furthermore, effective training modalities that examine the transformation of nursing students’ knowledge into practice through the development of confidence during experiential learning have not been well explored.

Purpose: Evaluate the effectiveness of a HL information and a HL telesimulation intervention on the HL Knowledge, Application and Confidence of first-semester …

Clinical Simulation Training To Increase Medical Surgical New Graduate Registered Nurse (Ngrn) Confidence And Competence When Caring For Deteriorating Patients: A Quality Improvement Project, Tammy Schwaab

Doctor of Nursing Practice (DNP) Manuscripts

Problem: Patient harm from preventable cardiac arrest continues despite implementation of Rapid Response Teams (RRT) in the hospital setting. Medical surgical NGRNs lack adequate practice experience to prepare themselves with the competency skills necessary to manage high acuity patients in a complex healthcare environment. An awareness of a lack of readiness for practice leads to low NGRN self-confidence. Deficiencies in NGRN self-confidence and clinical competence lead to an inability to recognize and respond to patient complications with subsequent ineffective use of the RRT. Failure to Rescue (FTR) is one of the top three medical errors committed by NGRNs. Current evidence …

A Feasibility Study To Identify If The Induction Of The Relationship Based Care Program Enhance The Caring Skills Of Registered Nurses?, Jennifer Millet

UNLV Theses, Dissertations, Professional Papers, and Capstones

The purpose of this Doctor of Nursing Practice project was to educate the Registered Nurses (RNs) to implement the Relationship Based Care (RBC) model and Jean Watson’s Theory of Human Caring principles into their practice. The model and principles were put into practice by the RNs, followed by examining the RNs perception and practices of caring and confidence skills had improved after the intervention. The mission of this project was to promote quality outcomes and patient satisfaction through caring relationships. Strengthening these relationships will help the caregiver experience the essence of care and be able to better connect to another …

Effects Of The Covid-19 Pandemic On The Health Behaviors And Feelings Of Career Preparedness Of Baccalaureate Nursing Students, Mary Haggard

The Eleanor Mann School of Nursing Undergraduate Honors Theses

The aim of this study was to determine if the COVID-19 pandemic affected the health behaviors and feelings of career preparedness of undergraduate nursing students. Participants were recruited from the pre-licensure program at the Eleanor Mann School of Nursing, at the University of Arkansas, Fayetteville during the Fall 2021 semester. The final sample consisted of 92 participants. This study used a cross-sectional design, retrospectively measuring behaviors and attitudes pre-pandemic and during the lockdown period. Two-tailed paired t-tests were run on the health behavior sections and feelings of career preparedness sections independently. Results were deemed significant with an alpha value set …

Educating Healthcare Professionals To Identify And Care For Victims Of Human Trafficking, Kathleen L. Messman, Allyson Neal

Graduate Publications and Other Selected Works - Doctor of Nursing Practice (DNP)

Background: Health Care Professionals (HCPs) report a need for education, training, and appropriate healthcare guidelines to identify and treat those affected by human trafficking. Approximately 88% of survivors report having been in contact with an HCPs while being trafficked without the knowledge or intervention of an HCP. Population: 16 staff from a Federally Qualified Health Center in rural in East Tennessee, including medical and dental staff, mental health counselors and receptionists attending onsite training. Methods: A pretest-posttest-4 week follow up posttest design was utilized to determine whether an educational intervention increased knowledge and confidence in HCPs. A modified PROTECT Provider …

Using A Deterioration Index Score To Improve Patient Outcomes, Amanda Doub

Doctor of Nursing Practice Projects

Quick recognition and response to clinical deterioration have a significant impact on patient mortality and outcomes. Nurses’ confidence in their ability to recognize signs and symptoms of deterioration and activate rapid response teams (RRT) is vital in preventing code blues and transfers to a higher level of care. The objective of this project was to determine the effect of an educational intervention on nurse acknowledgment of the deterioration index score and nurse confidence in intervening to improve patient outcomes by alerting the Rapid Response Team (RRT) within two months for adult patients on a medical-surgical unit. Findings from the project …

Implementation Of A Training Program To Improve The Crna Precepting Experience At An Academic Medical Center, Megan Jean Gillespie

Graduate Theses, Dissertations, and Problem Reports

Formal preceptorship training has been shown to improve the comfort and confidence with precepting across many disciplines. Currently, there is no training program in place for the Certified Registered Nurse Anesthetist (CRNA) preceptors at a large academic medical center in West Virginia. The overarching goal of this quality improvement (QI) project was to implement a formal preceptorship training for the CRNAs at the facility of interest. The training, or intervention, was the Preceptor Essentials Parts I and II on NetLearning. This project followed the pre-intervention-post-survey design. The participants were self-selected CRNAs. The survey results were analyzed using the Mann-Whitney U …

Improving Medical-Surgical Nurses’ Confidence In Initiating The Code Blue Process, Moung Sui A. Lee

Master's Projects and Capstones

Lack of confidence in responding to codes can decrease patient outcomes, for any delay in care reduces the chances of revival. As codes occur less frequently in medical-surgical units, nurses who work in this specialty are not as equipped to respond to codes like their ICU or ER colleagues. To address this concern, a code blue readiness training was implemented in six different medical-surgical units of an East Bay hospital. Pre and post surveys were utilized for data comparison on nurses’ confidence in responding to various steps of a code. The results revealed an overall increase in confidence. For this …

Improving Progressive Care Nurses’ Confidence And Performance During In-Hospital Cardiac Arrest (Ihca): A Continuous Quality Improvement Initiative, Katelyn Barley

Doctor of Nursing Practice (DNP) Manuscripts

The literature is clear regarding the benefits of high-quality cardiopulmonary resuscitation (CPR) in relation to patient outcomes. The American Heart Association (AHA) guidelines recommend immediate initiation of chest compressions and defibrillation as soon as possible to increase the chance of survival from cardiac arrest. The development of automatic external defibrillators (AEDs) have increased the survival rates of out-of-hospital cardiac arrest, however rates of survival from in-hospital cardiac arrest (IHCA) have not improved over the past several decades despite an increase in resuscitation research.

This project was to develop a system of quality improvement related to patient outcomes from IHCA. The …

The Need For A Sepsis Screening Tool In An Outpatient Facility, Michael C. Ciccarone, Terrica Durbin

Graduate Publications and Other Selected Works - Doctor of Nursing Practice (DNP)

Sepsis is an exaggerated inflammatory response generated by the immune system secondary to the presence of septicemia, or pathogens within the bloodstream. An average of 270,000 individuals die from sepsis each year, while a total of 1.7 million cases occur annually. Research has shown that the early identification of sepsis prior to hospital admission is associated with decreased lengths of stay, hospital-associated costs, and overall mortality. To demonstrate this research, 26 healthcare staff members in an outpatient clinic were provided with a pre-survey, qSOFA sepsis screening tool, and a post survey to determine if these materials
increased participant confidence when …

Confidence, Interest And Intentions Of Final-Year Nursing Students Regarding Employment In General Practice, Kaara Ray B. Calma, Susan Mcinnes, Elizabeth Halcomb, Anna Williams, Marijka Batterham

Nursing Papers and Journal Articles

Background: Rising health care burden has increased demand for general practice nurses. Exploring final-year nursing students’ perceived levels of confidence, interest and intention to work in this area can inform preparation and recruitment of new graduates into this workforce.

Aim: To explore final-year nursing students’ confidence, interest and intention to work in general practice.

Methods: Final-year nursing students from five universities situated in New South Wales, Australia were surveyed between March and June 2019. The survey comprised investigator-developed questions and validated tools adapted for use in general practice.

Findings: Of the 355 included responses, 34.1% respondents had a clinical placement …

Impact Of A Novel Application In Electrocardiogram Interpretation Confidence And Performance In Nurse Practitioner Students, Hailey Bobin Cole

Doctor of Nursing Practice Projects

For the last hundred years and to this day, one of the most important diagnostic tools in medicine has been the electrocardiogram (EKG or ECG). The decision to pursue a life-saving intervention, or not, may be heavily based on the interpretation of the results of a diagnostic test. With the weight of impacts to outcomes, one would think there would be ample, if not excessive, time and effort given to teaching practitioners how to interpret an ECG. Unfortunately, with each graduating class of physicians, nurse practitioners, and physician assistants, all of whom have within their scope of practice to interpret …